... Mothers' Intentions Run Counter to CDC Recommendations ...CINCINNATI April 30 /- Because the first national study...The study will be presented May 4 at the American Academy of Pediatric... Because HPV is the most common sexually transmitted infection (seeba...

CINCINNATI, April 30 /PRNewswire/ -- Because the first national study
of its kind has found that U.S. mothers report they are less likely to
vaccinate daughters under age 13 against human papillomavirus virus (HPV),
even though the vaccine is recommended for girls at age 11 and 12, it's
incumbent upon the healthcare community to work to improve moms' acceptance
of the vaccination for younger daughters, say researchers at Cincinnati
Children's Hospital Medical Center who conducted the study. HPV is a
sexually transmitted virus known to cause cervical cancer.

The study will be presented May 4 at the American Academy of Pediatrics
Presidential Plenary session, of the annual meeting of the Pediatric
Academic Societies in Honolulu.

"Because HPV is the most common sexually transmitted infection (see
background information below) and often acquired soon after the onset of
sexual activity, the CDC recommends that HPV vaccination ideally occur
before a girl becomes sexually active, as the vaccine will not reverse HPV
infection," says Jessica Kahn, M.D., a physician in the division of
adolescent medicine at Cincinnati Children's and the study's lead author.
Currently the U.S. Centers for Disease Control and Prevention (CDC)
recommends that 11- and 12-year-old girls be targeted for HPV immunization.
But the researchers found that mothers surveyed are currently not inclined
to follow that guideline.

In the study, while 86 percent of moms intended to vaccinate a 16- to
18-year-old daughter, and 68 percent intended to vaccinate a 13- to
15-year-old daughter, fewer than half -- only 48 percent -- intended to
vaccinate a 9- to 12-year-old daughter, according to the data analyzed by
Dr. Kahn and her colleagues. "Mothers' intention to vaccinate against HPV
is lowest for the younger daughters. Yet, younger girls are more likely
than older girls to benefit from vaccination, which is why the CDC
recommends that they be targeted for vaccination. This discrepancy between
mothers' attitudes and CDC recommendations represents a challenge for
health care providers."

"We found that mothers' beliefs about HPV vaccination are the most
powerful determinants of whether they intend to vaccinate their daughters
at this age. The findings of our study, in combination with results of the
evolving literature on HPV vaccine acceptability, provide information that
can be used to improve moms' acceptance of HPV vaccination for their
younger daughters."

Factors independently associated with intention to vaccinate a younger
daughter included belief that one's daughter should get a regular Pap
screen and beliefs about HPV vaccines. The seven-item scale measuring
beliefs about HPV vaccines included perceived benefits to HPV vaccination
(such as whether that vaccination will protect one's daughter against
cervical cancer), perceived barriers to vaccination (such as whether that
vaccination may lead to riskier sexual behaviors), belief that the daughter
is at risk for HPV infection, belief that HPV-related diseases such as
cervical cancer are serious, and belief that one's doctor would recommend
vaccination.

Dr. Kahn said that the most powerful individual predictors that were
most associated with likelihood to vaccinate their younger daughters were
(in order): belief that HPV vaccination would provide protection against
cervical cancer, belief that vaccinated girls would not practice riskier
sex, belief that one's daughter's clinician would recommend HPV vaccines
for her, and belief that one's daughter is at risk for HPV infection.

"Because we found moms' personal beliefs play such an important role in
their decisions to have younger daughters immunized against HPV, the
development of evidence-based messages that emphasize adolescent girls'
risk for HPV infection, the effectiveness of the vaccine in preventing
cervical cancer, and clinician endorsement of vaccination may increase the
acceptability of the HPV vaccine among parents and help to maximize HPV
vaccine uptake," says Dr. Kahn. "A comprehensive approach to enhancing
parental acceptability of HPV vaccination would involve the combined
efforts of clinicians, health educators, advocacy groups, and public health
personnel."

For the study, Dr. Kahn and her colleagues surveyed 10,521 mothers of
adolescents enrolled in the Growing Up Today Study (GUTS), a longitudinal
study of the children of mothers participating in the Nurses Health Study
II (NHS 2), between June 2006 and February 2007. The survey assessed
demographic factors, gynecologic history, communication with daughters
about Pap screening, and mothers' beliefs about Pap testing and about HPV
vaccines as well as intention to vaccinate daughters of varying ages.
Researchers also looked at mothers' intention to get the vaccine themselves
and found that 48 percent intend to be vaccinated.

Dr. Kahn's study was funded by the American Cancer Society and included
researchers from Indiana University, the University of Texas Medical Branch
Galveston and Harvard University Medical School. The senior author was
Lindsay Frazier, M.D., Children's Hospital Boston.

The PAS meeting is the largest international meeting focused on
research in child health. It is sponsored by the American Academy of
Pediatrics, the American Pediatric Society, the Society for Pediatric
Research, and the Ambulatory Pediatric Association.

BACKGROUND ON HPV: An estimated 6.2 million people 14 to 44 years old
are newly infected with HPV each year in the United States, and of these
infections, 74 percent occur among those 15 to 24 years old, according to
the CDC. Infection with one of the more than 100 types of HPV usually
causes no symptoms and resolves on its own, but a proportion of women
infected with specific cancer-associated types may develop cervical cancer.
Two of these types, 16 and 18, cause about 70 percent of cervical cancers
in women. Two other types, 6 and 11, cause about 90 percent of genital
warts. The CDC estimates that 11,100 new cervical cancer cases were
diagnosed in 2007 and approximately 3,700 women died from cervical cancer
in the U.S. Health care professionals use the Pap test to screen for
cervical cancer.

In June 2006, the U.S. Food and Drug Administration approved a vaccine
against four types of HPV, 6, 11, 16 and 18, based on data from clinical
trials indicating that the vaccine was highly effective in preventing
persistent infection with these strains and subsequent cervical cancer
precursor lesions, vaginal and vulvar cancer precursor lesions and genital
warts. The FDA approved the HPV vaccine for use in U.S. women aged 9 to 26
years.

Cincinnati Children's Hospital Medical Center, one of the leading
pediatric research institutions in the nation, is dedicated to changing the
outcome for children throughout the world. Cincinnati Children's ranks
second among all pediatric institutions in the United States in grants from
the National Institutes of Health. It has an established tradition of
research excellence, with discoveries including the Sabin oral polio
vaccine, the surfactant preparation that saves the lives of thousands of
premature infants each year, and a rotavirus vaccine that saves the lives
of hundreds of thousands of infants around the world each year. Current
strategic directions include the translation of basic laboratory research
into the development of novel therapeutics for the treatment of disease,
and furthering the development of personalized and predictive medicine.
Additional information can be found at http://www.cincinnatichildrens.org.

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